Efficacy and safety of a colostrum- and Aloe vera-based oral care protocol to prevent and treat severe oral mucositis in patients undergoing hematopoietic stem cell transplantation: a single-arm phase II study.

Oral mucositis is one of the worst effects of the conditioning regimens given to patients undergoing hematopoietic stem cell transplantation. It is characterized by dry mouth, erythema, mucosal soreness, ulcers, and pain, and it may impact patient outcomes. Bovine colostrum and Aloe vera contain a wide variety of biologically active compounds that promote mucosal healing. A non-randomized phase II study was designed to assess the safety and efficacy of a combined bovine colostrum and Aloe vera oral care protocol to prevent and to treat severe oral mucositis in transplant patients. Two commercially available products were given to patients in addition to the standard protocol: Remargin Colostrum OS® mouthwash and Remargin Colostrum Gastro-Gel® taken orally. Forty-six (78.0%) patients experienced oral mucositis, 40 (67.8%) developed mild-moderate forms, and 6 (10.2%) severe ones. Comparing the study group's outcomes with those of a homogeneous historical control group, severe oral mucositis decreased significantly (10.2% vs. 28.4%; P < 0.01), as did its duration (0.5 ± 1.9 vs. 1.5 ± 3.0 days; P < 0.01). Febrile neutropenia episodes (69.5% vs. 95.1%; P < 0.01) and duration (4.0 ± 4.7 vs. 6.2 ± 4.5 days; P < 0.01) also decreased. These findings show that the experimental protocol seems effective in preventing severe forms of oral mucositis. However, a randomized controlled trial is necessary to confirm this.

Aloe vera and wound healing: a brief review

Abstract Aloe vera possesses a great therapeutic importance in traditional medicine. It has attracted the attention of modern medical fields due to its wide pharmacological applications. The bioactive substances in Aloe vera proved to have antioxidant, anti-inflammatory, antibacterial, and antiviral properties. Taken into our consideration the long history of clinical applications of Aloe vera in traditional medicine, especially for promoting the healing of cutaneous wounds with rare adverse effects, it provides a cheap alternative to many expensive synthetic drugs. Recent techniques in tissue engineering created novel scaffolds based on Aloe gel extracts for wound healing applications. Nonetheless, further guided researche is required to foster the development of Aloe vera based scaffolds for the benefit of worldwide populations. Here, I systemically summarize the main events following wounding and the mechanism of action of Aloe vera in promoting the healing process. I hope to provide a solid piece of information that might be helpful for designing new research studies into this topic.

Comparison of the effect of ginger and aloe vera mouthwashes on xerostomia in patients with type 2 diabetes: A clinical trial, triple-blind / Comparación del efecto de los enjuagues bucales de jengibre y aloe vera sobre xerostomía en pacientes con diabetes tipo 2: un ensayo clínico, triple ciego

Background: Ginger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimedto compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Ab-bas diabetes clinic (Iran).Material and Methods: In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied.One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group wasonly given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. Thesymptoms and severity of xerostomia were measured before and after the intervention by the questionnaire pro-posed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test usedto measure the normality of variables, and Chi-square and McNemar used to compare the scores questionnaireproposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 wasconsidered as statistically significant in all these tests.Results: The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scoresof xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the gin-ger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severityrelated to xerostomia, respectively(p<0.001). Conclusions: The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloevera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According tothe results of this study, ginger and aloe vera mouthwashes could...(AU)

Oesophageal ulcer due to a herbal remedy.

Herbal-induced oesophageal lesions are rare. We report the case of an 85-year-old male who presented with cough and odynophagia. An upper endoscopy showed white deposit under the proximal oesophageal sphincter. Biopsy of the lesion revealed an oesophageal ulcer with adherent plant material and ruled-out candidiasis. At this point, the patient divulged self-preparation of an herbal remedy consisting of Aloe Vera pulp, whisky, honey, ginger and turmeric. Aloe Vera, ginger and turmeric are commonly used to sooth some gastroenterological symptoms in Complementary and Alternative Medicine. Incorrect extraction of Aloe Vera pulp and adding honey to it transformed the recipe into a sticky paste that may have injured the oesophageal mucosa. Follow-up showed that the cough and odynophagia subsided after discontinuing this herbal remedy.

Hepatitis tóxica tras tratamiento concomitante con interferón beta y aloe vera en un paciente con esclerosis múltiple: a propósito de un caso / Toxic hepatitis after concomitant interferon beta and aloe vera treatment in a patient with multiple sclerosis: A case report

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Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report.

Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes.

Aloe vera-induced acute liver injury: A case report and literature review.

Recent data suggest that herbal and dietary supplements are the second most common cause of liver injury. We herein report a case of acute liver injury in a 68-year old female caused by ingestion of Aloe vera. Upon discontinuation of the oral Aloe vera, liver function tests (LFT) returned to normal levels. Thus, it is crucial to consider the use of herbal products as causative agents of acute liver injury.

Tratamiento de las úlceras por presión con Aloe Vera / No disponible

Objetivos: Presentar una información actualizada acerca de la aplicación del Aloe Vera en las úlceras por presión (UPP). Material y métodos: Búsqueda bibliográfica de los artículos publicados, entre 2004 y 2014, en diferentes bases de datos biomédicas. Resultados: La evidencia confirma que puede ayudar en la prevención y en el tratamiento de UPP de grado I y II. Sin embargo no existen referencias que justifiquen su uso en las UPP III y IV. Conclusiones: La Organización Mundial de la Salud (OMS) recomienda a los gobiernos que sitúen la seguridad del paciente en el centro de las Políticas Sanitarias, destacando medidas cómo la prevención y el tratamiento de las UPP

Objectives: To show updated information about the implementation of Aloe Vera in the treatment of pressure ulcers. Material and methods: Literature search of articles published, between 2004 and 2014, in different biomedical databases. Results: The evidence confirms that Aloe Vera can help in the prevention and treatment of pressure ulcers of grade I and II. However, there are no references that justify its use in pressure ulcers III and IV. Conclusions: The World Health Organization (WHO) recommends that governments put patient safety at the center of Health Policy, emphasizing measures like prevention and treatment of pressure ulcers

Contact dermatitis as an adverse reaction to some topically used European herbal medicinal products - part 1: Achillea millefolium-Curcuma longa.

This review focuses on contact dermatitis as an adverse effect of a selection of topically used herbal medicinal products for which the European Medicines Agency has completed an evaluation up to the end of November 2013 and for which a Community herbal monograph has been produced. Part 1: Achillea millefolium L.-Curcuma longa L.

Herbal hepatotoxicity: analysis of cases with initially reported positive re-exposure tests.

BACKGROUND: Positive re-exposure tests are diagnostic hallmarks for hepatotoxicity. OBJECTIVE: To test validity of positive re-exposures in herb induced liver injury. METHODS: We searched Medline database for cases of herb induced liver injury with positive re-exposures and analysed 34 cases for positive re-exposure test criteria of baseline alanine aminotransferase< 5N before re-exposure, and re-exposure alanine aminotransferase ≥ 2× baseline alanine aminotransferase. Re-exposure test was negative, if baseline alanine aminotransferase< 5N combined with re-exposure alanine aminotransferase< 2× baseline alanine aminotransferase, or if baseline alanine aminotransferase≥ 5N regardless of the re-exposure alanine aminotransferase including no available re-exposure alanine aminotransferase result. RESULTS: In 21/34 cases (61.8%), criteria for a positive re-exposure were fulfilled, with negative tests in 6/34 cases (17.6%) or uninterpretable ones in 7/34 cases (20.6%). Confirmed positive re-exposure tests established potential of herb induced liver injury for Aloe, Chaparral, Chinese herbal mixtures, Chinese Jin Bu Huan, Chinese Syo Saiko To, Germander, Greater Celandine, Green tea, Kava, Mistletoe, Polygonum multiflorum, and Senna, with up to 4 case reports per herb. CONCLUSIONS: Among 34 cases of herb-induced liver injury with initially reported positive re-exposure tests, 61.8% of the cases actually fulfilled established test criteria and provided firm diagnoses of herb induced liver injury by various herbs.

Propriedades farmacológicas da Aloe vera (L. ) Burm. f / Pharmacological activities of Aloe vera (L. ) Burm. f

A Aloe vera (L.) Burm.f. tem sido utilizada há milhares de anos na medicina tradicional para o tratamento de diversos males. O intuito desse trabalho foi o levantamento bibliográfico de artigos que evidenciassem a atividade farmacológica da Aloe vera. A revisão contemplou livros e periódicos nacionais e internacionais indexados nas bases de dados MEDLINE, LILACS e SciElo, nos idiomas português, inglês e espanhol, utilizando as palavras-chave citadas. Após o levantamento bibliográfico, constatou-se que várias atividades biológicas são atribuídas a Aloe vera. Evidências sugerem eficácia no tratamento da psoríase, herpes genital, queimaduras e hiperglicemia. Além disto, também foram demonstradas atividades antineoplásica, antimicrobiana, anti-inflamatória e imunomodulatória por estudos in vitro e in vivo, entretanto, na cicatrização de feridas, os resultados foram conflitantes. No tratamento de dermatite por radiação e em queimaduras solares sua eficácia não foi comprovada e foram relatados casos de hepatite aguda devido ao consumo de preparações orais. Tendo em vista as várias atividades comprovadas e poucos relatos acerca de sua contra indicação, conclui-se que o uso desta espécie corrobora o vasto uso popular.

The Aloe vera (L.) Burm.f. has been used for thousands of years in traditional medicine to treat various ailments. The aim of this study was to carry out a bibliographical review on the pharmacological activity of Aloe vera. This review included books and national and international journals indexed to MEDLINE, LILACS and SciELO, in Portuguese, English and Spanish, using the key words mentioned. After the literature review, we found that several biological activities have been attributed to Aloe vera. Evidence suggests efficacy in the treatment of psoriasis, genital herpes, burns and hyperglycemia. Moreover, antineoplastic, antimicrobial, anti-inflammatory and immunomodulatory activities have also been demonstrated by in vitro and in vivo studies; however, in wound healing, the results were conflicting. In the treatment of radiation dermatitis and sunburn, its efficacy has not been proven, and cases of acute hepatitis from the consumption of oral preparations have been reported. Considering the various proven activities and the few reports about the contraindications of Aloe vera, we conclude that the use of this species confirms its wide popular usage.

Urticaria de contacto por Aloe vera / Contact urticaria by Aloe vera

El Aloe vera es un producto ampliamente usado en alimentación y cosmética. Aunque es considerado una planta medicinal por sus múltiples propiedades, no es un producto inocuo, ya que presenta ciertos componentes irritantes que pueden producir efectos secundarios. La dermatitis alérgica de contacto se presenta entre los mismos. Presentamos el caso de un niño de seis años en el que observamos una urticaria tras la aplicación directa del jugo de la planta de Aloe, con buena respuesta al tratamiento convencional de la urticaria. Tras esta revisión bibliográfica, podemos concluir que no puede recomendarse el uso de Aloe vera para el tratamiento de ninguna patología específica debido a que no existe suficiente evidencia de su eficacia en la práctica clínica (AU)

Aloe vera is a widely used product in the food sector and the cosmetics industry. Although it is considered to be a medicinal plant because of its many properties, it is not an innocuous product as it has certain irritating components which can cause side effects. Allergic contact dermatitis is included among them. We present the case of a six-year-old child who shows urticaria after applying the juice of the Aloe plant directly onto the skin. The patient responded successfully to conventional urticaria treatment. After this literature review we can conclude that the use of Aloe vera cannot be recommended for the treatment of any specific pathology since there is not enough evidence to prove the effectiveness in clinical practice (AU)

Aloe vera: no siempre tan beneficioso en pacientes con hepatopatía crónica / Aloe vera: not always so beneficial in patients with chronic liver disease

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Review of the efficacy of green tea, isoflavones and aloe vera supplements based on randomised controlled trials.

We assess the evidence for health benefits of three commonly consumed plant food supplements (PFS), green tea, isoflavone and aloe vera, based on published systematic reviews of randomised controlled trials (RCTs). Whilst the potential benefits of green tea have been reported in a wide range of health areas, it is only in the area of the metabolic syndrome that the number of RCTs is approaching sufficient to judge such efficacy. Isoflavone supplements are widely used, and RCTs indicate that they affect bone resorption at lower doses in postmenopausal women undergoing estrogen-related bone loss, but this is only translated to attenuation of bone loss at higher doses of isoflavones. A systematic review on RCTs concluded that the effects of isoflavones on hot flashes in postmenopausal women were highly variable and no conclusions could be drawn. Despite the popularity of aloe vera as a PFS, the evaluation of its efficacy as a coadjuvant therapy for certain metabolic or digestive pathologies remains scarce; it constitutes a typical example of a naturally occurring ingredient whose efficacy in topical applications presupposes its efficacy in systemic applications. Nevertheless, its possible toxic effects on oral consumption call for caution in its utility as a PFS. Since 2007, efficacy evaluation of PFS in Europe has been covered by European Union Nutrition and Health Claims legislation. The European Food Safety Authority has adopted an approach relying on RCTs, while medicinal effects are accepted based on traditional use. In general, there are insufficient RCTs for claims to be made, and conclusive results on PFS should be obtained in the future by conducting studies with more homogeneous populations, by using supplements with optimised and measured bioavailability, and by conducting larger RCTs.

Utilização da babosa no cotidiano de usuários portadores de câncer / Use of aloe in the daily life of patients with cancer / Utilización de la aloe en el cotidiano de pacientes portadores de cáncer

O estudo teve como objetivo investigar a utilização da Aloe spp. pelos usuários portadores de câncer, no tratamento da doença. Trata-se de um estudo qualitativo, descritivo e exploratório, realizado em um município do Sul do Rio Grande do Sul com onze usuários portadores de câncer internados no Programa de Internação Domiciliar Interdisciplinar (PIDI)Oncológico. Destes, nove sabiam sobre a possibilidade de utilização da Aloe spp. para o câncer e apenas três referiram sua utilização para auxiliar no tratamento. A Aloe spp. foi utilizada pelos usuários, visando auxiliar no tratamento do câncer, sem abandonar o tratamento convencional. Concluiu-se que, apesar de os entrevistados terem relatado o uso da babosa, não se encontraram estudos que confirmassem suas propriedades anticancerígenas.

The objective of this study is to investigate the use of Aloe spp. by users with cancer,in the treatment of the disease. This is a descriptive, exploratory and qualitative study carried out in a municipality of Rio Grande do Sul with 11 users with cancer interned interned at the Oncological Interdisciplinary Home Care Program (IHCP). Nine out of the eleven patients had heard of the possibility of using Aloe spp. for cancer treatment and the remaining three reported having used it as a support in the treatment. Aloe spp. was used by the patients as an auxiliary a cancer treatment, without abandoning the conventional one. It was concluded that inspite of the fact that the interviewees reported having used of Aloe, no studies were found to confirm its anti-cancer properties.

El estudio tuvo como objetivo investigar el uso de la Aloe spp., por pacientes portadores de cáncer, en el tratamiento de la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado en un municipio, del Sur del Rio Grande do Sul, con once pacientes portadores de cáncer internados en el Programa de Internación Domiciliario Interdisciplinario (PIDI)Oncológico. De estos, nueve sabían sobre la posibilidad de la utilización del Aloe spp. para el cáncer y solo tres refirieron su uso como auxiliar en el tratamiento. El Aloe spp. fue utilizado por los pacientes, con la finalidad de auxiliar en el tratamiento del cáncer, sin abandonar el tratamiento convencional. Se concluye que, a pesar de que los encuestados hayan relatado sobre el uso del Aloe, no se encontraron estudios que confirmasen sus propiedades anticancerígenas.

Oral Aloe vera as a treatment for osteoarthritis: a summary.

While pain relief is a basic tenet of health care, pain is under-treated in the UK (Davies and Mcvicar, 2000) and this issue remains unresolved. This paper suggests that oral Aloe vera could be used in the treatment of chronic non-cancer pain (CNCP), particularly that caused by osteoarthritis (OA). Despite being used as arthritis treatment for centuries (Yoo et al, 2008), evidence of effectiveness of Aloe vera is anecdotal or from small studies. The perceived benefits of prescribing Aloe vera for OA may be twofold: it has utility as an anti-inflammatory agent and also as a prophylactic against the gastrointestinal irritant effects of non-steroidal anti-inflammatory drugs (NSAIDs). Long-term, randomized, controlled studies are still needed to address the lack of evidence informing optimum prescribing of pain medication for people with OA (Cowan, 2007). There is no reason that so called 'nutraceutical' agents should not be subjected to the same rigorous randomized, controlled, double-blind trials as other 'mainstream' drugs. Therefore, it is appropriate to ask whether NSAID treatment and side effects can be improved by the addition of oral Aloe vera. Thus, we may then be in a more informed position to resolve the ongoing 'Pandemonium over Painkillers' (Cowan, 2007).

Aloe vera as a functional ingredient in foods.

The main scientific discoveries on Aloe vera published mainly in the last three decades are presented in this work. After describing Aloe from a botanical point of view, the papers related with the chemical composition of different parts of the leaf of Aloe, particularly those in which the gel is described and are presented in a synthetic manner. The chemical analyses reveal that Aloe gel contains mannose polymers with some glucose and other sugars, among which the most important is Acemannan. Besides these, other components such as glycoproteins, enzymes, amino acids, vitamins, and minerals are described. Different factors also affecting the chemical composition of the gel, such as species and variety, climatic and soil conditions, cultivation methods, processing and preservation, are enumerated and discussed. On the other hand, the main therapeutic applications have been revised and the possible damaging effects of Aloe are also commented upon. A special emphasis is placed on the biologically active compounds or groups of compounds responsible for the therapeutic applications and which are their action mechanisms. The paper concludes that more research is needed to confirm the therapeutic and beneficial effects and to definitively clarify the myth surrounding Aloe vera. A general view on the problem of the commercialization and establishment of the quality and safety of Aloe products in the food industry has been offered here. The main points and European regulations that need to be considered regarding the quality control of prepared Aloe products are presented in this paper.